Lithium. (March 2016)

• Record Type: Journal Article
• Authors: Bradberry, Sally
• Is Part Of: Medicine. Volume 44:Number 3(2016)
• Page Start: 180
• Page End: 181
• Publication Date: 2016-03
• Subjects: Haemodiafiltration -- haemodialysis -- lithium -- poisoning; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Médecine factuelle -- Périodiques; Medicine; Periodicals; Electronic journals; Electronic journals; 610
• DOI: 10.1016/j.mpmed.2015.12.009
• Languages: English
• ISSNs: 1357-3039

Abstract

Abstract: Lithium has a narrow therapeutic index and most poisonings are chronic, secondary to impaired renal elimination. Neurological features predominate. Serum lithium concentrations must be interpreted according to the type of poisoning (acute, acute-on-therapeutic or chronic). Apart from symptomatic measures, the major therapeutic objective is to enhance lithium elimination either by administration of normal saline, if renal function is normal and poisoning is mild, or by extracorporeal removal by haemodialysis or haemodiafiltration. Haemodialysis or diafiltration is especially indicated in patients presenting with neurological symptoms, an increased serum lithium half-life and/or impaired renal lithium elimination.